NPIMap

Organization Active NPI

Community Counseling & Mentoring Services, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Largo, MD
National Provider Identifier
1417344896
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
100445 Issued in MD
Legal business name
COMMUNITY COUNSELING & MENTORING SERVICES, INC.
Practice address
1300 Mercantile LN
Suite 208
Largo, MD 20774-5327
Phone
(301) 583-0001
NPI assigned
Apr 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Anthony D Carvana Sr., MA
Title
President & Ceo
Phone
(301) 583-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 100445 MD Primary

Addresses

Primary practice location

1300 Mercantile LN
Suite 208
Largo, MD 20774-5327

Mailing address

1300 Mercantile LN
Suite 208
Largo, MD 20774-5327
Phone (301) 583-0001

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Mentoring Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1417344896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN",
            "address_2": "SUITE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "301-583-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN",
            "address_2": "SUITE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "301-583-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING & MENTORING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "CARVANA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "301-583-0001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "100445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.